Information - And Courage - Will Bring Mental Illness Into The Light

RICHARD ESTRADA

June 2, 1998|RICHARD ESTRADA Dallas Morning News

The first time I saw a person with mental illness, I was a child of 4 or 5. It was the most terrifying episode of my young life up to that point, mainly because I did not understand what had given rise to the shouting, the groaning and the crying of a young adult who had been brought to our house.

In the disruption of that peaceful New Mexico night over 40 years ago, an innocent child's fear of the unknown was only heightened by the conspiracy of silence that the grown-up relatives around me insisted on observing. Since then, I've come to learn one of the conspiracy's most closely guarded secrets: Adults often keep quiet about mental illness because they understand it little better than children do.

Immobilized by a fear of the unknown, those individuals closest to people exhibiting the first signs of mental illness _ who are often teen-agers and young adults _ too often cast aside a natural desire for logical explanations. They may instead choose explanations based on superstition. More often, they do nothing at all, or, worse still, they turn their backs on the mentally ill.

To counteract a passivity that experts now say has a great potential for self-destruction, groups such as the National Alliance for the Mentally Ill, based in Arlington, Va., are establishing hot lines and Web sites on the issue in order to publicize critical options. National figures like former first lady Rosalynn Carter and Sen. Pete Domenici, R-N.M., are taking the issue to the public.

Seeking to reassure themselves, loved ones of the mentally ill may give in to an adult proclivity for denial that can become needlessly devastating to those in need of professional help. Even among affluent and well-educated families, the stigma of mental illness can be great. Courageous figures such as Mike Wallace of CBS are beginning to change that by telling of their personal struggles with severe depression, struggles so great that they contemplated suicide.

That so many friends and loved ones of the mentally ill choose denial is a shame in every sense of the word. Too often, dramatic progress in healing some broken brains only underscores a tragedy of Shakespearean proportions when it comes to other, neglected, victims.

Too many people with mental illness never have access to help in the first place, or are misdiagnosed without follow-up evaluations or are given the wrong medication. Recent studies showing a disproportionate cut in spending on mental health by health care coverage providers suggest the problem may be getting worse. Psychiatric counseling in particular is being cut for those who need it most.

As researchers continue to learn more about how to treat mental illness, they are also learning more about just how high a toll ignorance can exact. Consider that of the 2 million people with schizophrenia in the United States today, one in 10 will ultimately commit suicide if current trends continue, according to the National Alliance for the Mentally Ill.

That sobering statistic is obviously unacceptable. And given the availability within the last decade of important new medications to treat mental illnesses such as schizophrenia, that statistic is why an unprecedented international suicide prevention study is now under way in the United States and Europe.

Called InterSePT, the clinical investigation will last two years, and will examine which of two new medications is better at reducing the risk of suicide and self-destructive behavior among patients with schizophrenia and schizoaffective disorder: clozapine (marketed as Clozaril) or olanzapine (marketed as Zyprexa).

Hope continues to grow, and just in time. Because not only do one out of 10 people with schizophrenia in this country commit suicide, experts at Novartis, a drug manufacturer, say about half the people with schizophrenia will attempt suicide in their lifetime. The heavy emotional and financial burden on their families can only be imagined.

Come the second week in June, nationally renowned specialists in behavioral disorders, including schizophrenia and severe depression, will announce the latest findings in their field at a major news conference in Boston. Fortunately, people no longer openly seek to explain mental illness by pointing to possession by evil spirits and many are focusing on medical science journals. A growing number of people know that early intervention and treatment are optimal, and that medications are being refined continuously.

Who knows? As people begin to fear the devilish diseases they don't know less and less, the conspiracy of silence may finally be eroding.